| NPI | 1609021740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CO 9901) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NM DD379) |
| Enumeration Date | 2008-11-17 |
| Last Update Date | 2020-01-08 |